Ultrasound in Practice
Many studies have shown that ultrasound (US) can detect inflammation and damage in rheumatoid arthritis (RA). The role of US in routine practice, however, has been less studied and is a hot topic.
A group of musculoskeletal ultrasound experts, who are also members of the independent TUI Steering Committee, has produced five algorithms suggesting when ultrasound can be used to aid diagnosis, inform the assessment of treatment response/disease monitoring and to evaluate stable disease state or remission in patients with suspected or established rheumatoid arthritis. These were published in the Annals of the Rheumatic Diseases, Nov 2016, 75(11) 1902-1908;DOI 10.1136/annrheumdis-2016-209646
These pragmatic templates propose when ultrasound can be used at certain time points of rheumatoid arthritis management. Adding a targeted ultrasound assessment may improve diagnosis and treatment of patients with rheumatoid arthritis.
Professor Paul Emery TUI Chair
“An algorithmic approach to ultrasound evaluation may help to achieve the goal of improving rheumatoid arthritis diagnosis and management in daily, clinical practice.”
Professor Maria Antonietta D'Agostino TUI Deputy Chair
Two algorithms propose when ultrasound evaluation may aid diagnosis in patients at risk of rheumatoid arthritis (RA) or suspected RA and in patients who fulfil the American College of Rheumatology/(ACR)/European League Against Rheumatism (EULAR) criteria.
Algorithms showing ultrasound evaluation of therapeutic response in rheumatoid arthritis patients starting on conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biological disease-modifying antirheumatic drugs (bDMARDs) and also in patients with loss of treatment response.
Algorithm showing ultrasound evaluation in assessing remission or low disease activity in rheumatoid arthritis patients.
How might ultrasound add value to aid diagnosis, inform therapeutic response and the assessment of disease state.View examples